Recording of Severe Mental Illness in United Kingdom Primary Care, 2000–2010
Open accessAbstract
BACKGROUND: There is increasing emphasis on primary care services for individuals with severe mental illnesses (SMI), including schizophrenia, bipolar disorder, and other non-organic psychotic disorders. However we lack information on how many people receive these different diagnoses in primary care. Primary care databases offer an opportunity to explore the recording of new SMI diagnoses in representative general practices. METHODS: We used data from The UK Health Improvement Network (THIN) primary care database including longitudinal patient records for individuals aged over 16 years from 437 general practices. We determined the annual GP recorded rate of first diagnosis of SMI by age, gender, social deprivation and urbanicity between 2000 and 2010. RESULTS: We identified 10,520 individuals with a first record of schizophrenia, bipolar disorder or other non-organic psychosis among 4,164,794 patients. This corresponded to a rate of first diagnosis of 46.4 per 100,000 person years at risk (PYAR) (95% CI 45.4 to 47.4) in the 16-65 age group. The rate of first record of schizophrenia was 9.2 per 100,000 PYAR (95% CI 8.7 to 9.6) in this age group, bipolar disorder was 15.0 per 100,000 PYAR (95% CI 14.4 to 15.5) and other non-organic psychotic disorder was 22.3 per 100,000 PYAR (95% CI 21.6 to 23.0). CONCLUSIONS: The rates of GP recorded SMI in primary care records were broadly comparable to incidence rates from previous epidemiological studies of SMI and show similar patterns by socio-demographic characteristics. However there were some differences by specific diagnoses. GPs may be recording rates that are higher than those used to commission services.
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The assumption of proportional hazards was tested by analysis of Schoenfeld residuals.
“The assumption of proportional hazards was tested by analysis of Schoenfeld residuals.55”
From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [55]
The Materials and Methods > Statistical Analysis section describes Poisson regression and multilevel random-intercept models, but does not mention testing a proportional-hazards assumption. Searches for Schoenfeld residuals and proportional-hazards testing found no passage addressing the claimed test. No page number is available in our copy. (LLM, conf=0.76)
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- Authors
- Hardoon, S., Hayes, J. F., Blackburn, R., Petersen, I., Walters, K., Nazareth, I., & Osborn, D. P. J.
- Affiliations
- University College London (GB)
- Corresponding author
- Hayes, Joseph F
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-12-12
- Volume
- 8
- Issue
- 12
- Pages
- e82365
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3861391
- OpenAlex
- W2001183362
- Cited by
- 90
- References
- 43
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 5 · 2019: 3 · 2018: 2 · 2017: 9 · 2016: 12 · 2015: 10 · 2014: 3
- FWCI
- 12.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0609-10156)
- Medical Research Council (MR/K021362/1)
- Programme Grants for Applied Research (RP-PG-0609-10156)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- severe mental illness, schizophrenia, bipolar disorder, primary care, general practice, incidence, social deprivation, urbanicity, sociodemographic differences
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Bipolar Disorder, Demography, Female, United Kingdom, Humans, Male, Middle Aged, Primary Health Care, Schizophrenia, Time Factors, Databases, Factual, Young Adult, General Practice
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